Delivering Biomedical Information Services In FY 2009, NLM expanded the quantity and range of high quality information available to researchers, health professionals, and the general public. Among the NLMs intramural programs that contribute to its national biomedical information services are the following examples: PubMed/MEDLINE: PubMed, which incorporates MEDLINE, is NLMs premier bibliographic database with over 19 million references to biomedical journal articles. MEDLINE articles are indexed by experts using the Medical Subject Headings (MeSH) controlled vocabulary, updated annually. In FY2009, more than 700,000 new indexed citations were added. PubMed Central: The PubMed Central archive of over 1.8 million full-text journal articles is central to the NIH effort to make accessible the published results of research it supports. In FY09, NLM enhanced the NIH Manuscript Submission system (NIHMS) by which authors can submit articles to PubMed Central in compliance with the NIH Public Access Policy. NLM has also made PMC software available to archiving organizations in the UK and Canada. MedlinePlus and MedlinePlus en espaol: MedlinePlus and the Spanish language MedlinePlus en espaol provide access to consumer health information on more than 800 diseases and conditions. Recent enhancements included improved search capabilities, addition of summary information, and expansion to include information in more than 40 languages. Clinical Trials: ClinicalTrials.gov contains information on more than 79,000 clinical research studies in more than 169 countries, with hundreds added each week. It was significantly expanded to respond to new clinical trial registration and results reporting requirements established by the FDA Amendments Act of 2007 (PL 110-85). In FY09, some 32,000 trials were registered, raising the total to 79,000. Since NLM implemented the results database required by the law in September 2008, summary results of more than 880 clinical trials have been added. In September 2009, the previously optional adverse events module of the results database became mandatory. Toxicology and Environmental Health: The Toxicology Data Network (TOXNET) is a primary reference for toxicologists, poison control centers, public health administrators, physicians and other environmental health professionals, and includes databases such as Hazardous Substances Data Bank, TOXLINE, GENE-TOX, and the Toxic Release Inventory. Influenza Virus Resource: The Influenza Virus Resource contains influenza virus sequences and enables researchers to compare different virus strains, identify genetic factors that determine the virulence of virus strains, and look for new therapeutic, diagnostic and vaccine targets. Updated daily, it includes over 90,000 influenza sequences and more than 2,000 complete genomes. Disaster Preparedness and Response: NLMs Disaster Information Management Research Center facilitates access to disaster information, promotes effective use of libraries and disaster information specialists in disaster management efforts, and supports initiatives to ensure uninterrupted access to critical health information resources when disasters occur. A collaboration with the Bethesda Hospital Emergency Preparedness Partnership provides backup communication systems and develop tools for patient tracking, information sharing and access, and responder training, and to serve as a model for hospitals across the nation. Molecular Biology, Bioinformatics, and Human Genome Resources: NCBI information resources include molecular biology databases and bioinformatics software tools such as GenBank, Entrez, BLAST, RefSeq, UniGene, LocusLink, annotation and assemply of complete genomes, and the NCBI software toolkit. NCBI also produces the information retrieval systems for the PubMed, PubMed Central, and the NCBI Bookshelf. Some areas of emphasis in FY09 augmenting the Short Read Archive of more than 400GB of raw sequence data derived from massively parallel sequencing technologies;augmenting dbGAP with more than 20 GWAS studies and developing a new access system using the high-efficiency FASP protocol;and continuing the discovery initiative to alleviate difficulties in finding relevant information in diverse resources and develop interface improvements such as Releated Reviews and Patient Drug Information. Outreach: Promoting Public Awareness and Access Consumer health websites and the NIH MedlinePlus Magazine transmit the latest useful research findings in lay language. In FY09, NLM increased distribution of the magazine to 600,000, launched a Spanish language edition, Salud!, and introduced online versions the magazines. Special population websites address specific minority health concerns in various racial and ethnic groups. NLM outreach programs enhance awareness of its information services. Special attention is given to minority groups and other underserved populations, including African American, Hispanic, and Native American communities, as well as health professionals serving minority populations and practicing in rural and inner city communities. In FY 2009, dozens of community-based projects were funded across the country. Health Services Research NICHSR improves access to health services research through information systems such as: HSRProj, a database covering over 5000 ongoing or recently completed health services research projects;HSRR (Health Services and Sciences Research Resources), a database of research datasets, instruments and software relevant to health services research, behavioral and social sciences, and public health;and HSTAT (Health Services/Technology Assessment Text), a full-text database including evidence reports, guidelines technology assessments, consensus statements, and treatment protocols. Advanced Information Systems, Data Standards and Research Tools In FY 2009, LHC and NCBI continued to conduct research in biomedical informatics and computational biology information systems, tested the effectiveness of medical informatics interventions, and developed new scientific computing tools. To cite a few examples, intramural researchers developed tools that support standards-based personal health records;applied natural language processing methods to extract information from biomedical literature;improved automatic detection of gene and protein names in scientific text;and provided software tools that enabled rapid expansion of the PubChem database. NLM made substantial contributions toward standardized reporting of genetic variations and clinical interpretation of genetic test results by augmenting RefSeqGene and dbSNP;expanding the LOINC;and launching the Newborn Screening Coding and Terminology Guide to enable more effective use of newborn screening test results. Health Data Standards: As the central coordinating body for clinical terminology standards within DHHS, NLM supports nationwide implementation of an interoperable health information technology infrastructure. NLM develops or licenses key clinical terminologies and problem lists designated as standards for U.S. health information exchange. The Unified Medical Language System Metathesaurus, with more than 7.7 million concept names from more than 100 vocabularies, is a distribution mechanism for standard code sets and vocabularies used in health data systems. NLM also produces RxNorm, a standard clinical drug vocabulary;supports the LOINC nomenclature for laboratory tests and patient observations;and promotes international adoption of the SNOMED CT clinical terminology. In FY09, NLM released the first version of the CORE Problem List Subset of SNOMED CT and launched the Newborn Screening Codes and Terminology Guide, which provides a standard framework for reporting the results of newborn screening tests.